Neurology – Dementia: By Gregg Day M.D. HD

medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME. Neurology – Dementia Whiteboard Animation Transcript with Gregg Day, MD https://medskl.com/Module/Index/dementia Contrary to popular belief, memory loss is not a normal part of aging. Just as age-related decreases in bone density are a sign of the disease osteoporosis, memory loss is commonly a symptom of dementia--where dementia is defined as progressive cognitive impairment that affects daily functioning. There are many causes for dementia; the most common cause in older individuals is Alzheimer disease. To evaluate the cause of a patient’s memory loss, the first step is a thorough history and physical. The history should establish a pattern of progressive memory and thinking problems, while probing for alternate explanations: things like medication changes or other active illnesses, including mood disorders. Interviewing a family member or close friend is often key to flushing out a patient’s history. The main focus of the physical examination should be to screen for signs that might point to a less common cause of dementia, or suggest a focal brain problem—such as a stroke or tumor. Conditions not excluded by history and examination can be tested with lab studies and neuroimaging. Generally, blood tests measuring thyroid function and vitamin B12 levels are a good place to start, then an MRI of the brain, if indicated. Establishing a clinical diagnosis provides the clinician with an opportunity to recommend treatments to improve symptoms and screen for comorbidities that may worsen memory or speed the progression of dementia – things like polypharmacy, depression and cerebrovascular disease. This also creates an opportunity to help the family and patient begin to plan for the future, and prepare to navigate important transitions at home and in their communities. So memory loss is not a normal part of aging. It is a symptom that demands careful consideration and investigation. The goal of which is to determine and treat the cause of the memory loss whenever possible, and to support the patient.